Living with Juvenile Arthritis

While it can’t be cured, juvenile arthritis can be well managed with long-term medications and therapy, and affected children can live normal lives, a CHOC Children’s rheumatologist says.

“There are such good medications available and there are some new biologic medications that are targeted and effective for treating most forms of arthritis in children,” says Dr. Sheryl J. Boon, division chief of rheumatology at CHOC. “The outlook now for kids with arthritis is much better than it was 20 years ago.”

Children with juvenile arthritis can be treated by their pediatrician or a specialist. Treatment goals are to control inflammation and swelling, relieve pain, prevent joint damage and help the child to move and function as much as possible, Dr. Boon says.

And there’s no reason that children with a form of juvenile arthritis can’t play sports and do all those activities other kids enjoy, she adds.

In fact, parents should try to make life as normal as possible for their child with juvenile arthritis, Dr. Boon advises. While they should try avoiding activities that cause extra stress on the joints, families shouldn’t dwell on the disease.

“We want the kids to feel like they are normal,” Dr. Boon says. “We don’t want them to feel disabled. Most of our kids take the normal P.E. classes and can do everything all the other kids can do.”

CHOC uses a team approach to treat children with arthritis, and includes care from physicians, nurses, a social worker, physical therapist and occupational therapist, Dr. Boon says.

“The social worker meets with all the family members and helps them cope with the chronic illness and any school-related issues, like making sure the kids have extra time between classes if they need it or no physical education if they need it,” she says.

The goal is to keep children active with arthritis.

“We can send the children to get physical and occupational therapy so they can get exercises and get moving again,” Dr. Boon says.

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Five Arthritis Myths Busted

Picture a person with arthritis. Do you see someone elderly with gray hair, glasses and knitting in tow?arthritis_myths

Think again: Arthritis is not just a grandmother’s disease. In fact, one in 10 of every 10,000 children will be diagnosed with Juvenile Idiopathic Arthritis every year in the United States, and an estimated 70,000 children have the condition nationwide.

“There are a lot of misconceptions about what arthritis is,” says Dr. Andrew Shulman, a CHOC Children’s rheumatologist.

And the misconception that arthritis is a disease of the elderly isn’t the only myth surrounding this condition.

Just in time for National Arthritis Awareness Month, Dr. Shulman helps debunk other misconceptions associated with arthritis.

Joint pain doesn’t always mean arthritis

The principal symptoms of arthritis are swelling, stiffness and limited range of motion. Pain is only sometimes a part of the symptoms felt by a person with arthritis, Dr. Shulman says.

“We have classic literature from our field that show that if a patient is referred to a rheumatologist with joint pain, they were more likely to be diagnosed with something other than arthritis,” he says.

Dr. Shulman says the term arthritis has incorrectly become a catchall phrase for joint pain.

“I think it’s one of these situations where the term has become common parlance for joint pain or joint issues,” he says. “There’s some overlap between the colloquial use of the term and what it actually is.”

Arthritis is not a precise diagnoarthritis_myths2sis

Dr. Shulman says that arthritis is not a diagnosis, and instead a symptom. A good comparison, he says, is a cough.

“A lot of things can cause a cough – lots of different things involving different organ systems,” Dr. Shulman says. “Arthritis is a finding and symptoms related to joint inflammation, but it can have many causes and is not a precise diagnosis.”

Many things such as an infection, medication exposure, or allergic reaction can trigger arthritis, Dr. Shulman says. In those cases, the arthritis can surface and then go away.

However, in some cases, the symptoms are persistent and chronic.

To confirm if a child has a form of juvenile arthritis, symptoms must have begun before the patient turned 16 and the arthritis must have been present in a particular joint for at least six weeks. Also, physicians must exclude other possible conditions before confirming a diagnosis of juvenile arthritis , Dr. Shulman says.

Arthritis is not diagnosed with lab tests

Arthritis is diagnosed primarily through patient history and examination findings, Dr. Shulman says. Once arthritis is confirmed, laboratory tests can help to characterize the arthritis.

Dr. Shulman says patients complaining of joint pain are often found to have abnormal test results, leading a physician to believe the patient has arthritis. But once the patient sees a rheumatologist, arthritis can be ruled out.

“Another way of saying it is that these tests can yield a false positive,” Dr. Shulman explains.

Arthritis is not a rare condition

Though arthritis is unusual in children, the condition is not rare, Dr. Shulman says.

Arthritis is more common in children than type I diabetes, he says.

Further, according to the Arthritis Foundation, more children have arthritis than juvenile diabetes, cystic fibrosis, cerebral palsy and muscular dystrophy combined.

Learn more about rheumatology at CHOC Children’s.

Related articles:

  • Living with juvenile arthritis: Mackenzie’s story
    The first 11 months of Mackenzie’s life were like most other children. But as she was on the cusp of learning to walk, her parents Danielle and Victor noticed that ...
  • Living with Arthritis: Carson’s Story
    Seventeen-year-old Carson comes from a close-knit family of athletes and had been playing baseball for a decade when consistent, unexplained pain left his family stumped and looking for answers. Countless ...
  • Chronic Inflammation and What it Means in a Child
    “Chronic inflammation can be manifest in many ways,” says Dr. Boon. “Signs parents might see in their child include fatigue, fever, rash, joint pain or swelling, sores in their mouth, ...